The present invention relates generally to an ophthalmic examination chair having integrated positioning system providing wheel chair access to an associated instrument stand for accommodating the examination of disabled patients.
Nineteen ninety two heralded the passage of the Americans with Disabilities Act (ADA) which extended the protection of the federal civil rights laws to disabled Americans in such areas as employment, public accommodations, state and local government services, public and private transportation, and telecommunication services. In particular, Title II of the ADA, which applies to all private entities that own, operate, or lease a "place of public accommodation," prohibits such entities from discriminating against the disabled. Specifically, the ADA requires each and every "place of public accommodation" to insure that no individual with a disability is excluded, denied services, segregated, or generally treated differently from other individuals because of the absence of auxiliary aids and services adapted to accommodate the disability. Penalties for violations of the ADA include monetary fines as high as fifty thousand dollars for the first infraction and one hundred thousand dollars for subsequent infractions, as well as temporary or permanent injunctive orders requiring the altering of facilities to prohibit continuing discrimination. A tax credit, however, has been made available for "eligible access expenditures" to help mitigate the expense of modifying or acquiring equipment or devices for providing goods and services to the disabled.
Although the passage of the ADA generally has been praised as rightly affording the over 40 million disabled Americans equal access to all public places, compliance with the provisions of the act often has proven to be both costly and difficult for many industries, businesses, and services. The medical professions too have been confronted with the problem of how to comply with the requirements of the ADA. Indeed, ensuring that the disabled have unrestricted access to needed medical care may be seen as a motivating factor behind the passage of the ADA.
As with all health care providers, the providers of ophthalmic and optometric services, such as ophthalmologists, optometrists, opticians, and the like have been exploring various ways of meeting their obligation of reasonable accommodation under the ADA. As usually equipped, the standard ophthalmic examination room involves an instrument stand having a movable arm supporting a refractor assembly, which assembly contains a number of adjustable testing lenses and, optionally, other eye examination instruments such as a keratometer and a slit lamp. The stand additionally may support a holder for such hand-held diagnostic instruments as an ophthalmoscope and a retinoscope. An examination chair is associated with the stand and is positioned with respect thereto such that refractor assembly may be placed confronting the eyes of the patient being examined. With the patient and the refractor assembly properly positioned, the examination procedure commences with the darkening of the examination room, and the observing by the patient of a distant target, such as an eye chart or the like, through the lenses of the refractor assembly. The examination chair is positioned to space the patient a predetermined distance from the eye chart which is calibrated to be read from a specified distance by the patient. The lenses of the refractor assembly then are adjusted using a trial-and-error procedure until the desired degree of vision correction is obtained. As the trial-and-error procedure may become somewhat involved and protracted, the comfort of both the patient and the examiner is of great importance. Accordingly, most examination chairs are designed to be adjustable as to height or degree of incline via an internally-contained pneumatic, mechanical, or electrical arrangement. Such an arrangement, however, adds to weight of the chair which may weigh several hundred pounds unloaded.
Given the weight of the examination chair and the need for it to be positioned in close adjacency to the instrument stand and at a predetermined distance from the eye chart, it generally is considered to be neither movable or portable once placed within the examination room. This poses difficulties for the provider where wheel chair bound patients are the subject of treatment. Indeed, the only options heretofore available for providers seeking to comply with the ADA requirements have been either to physically transfer the patient from the wheel chair to the examination chair, or to establish a separate examining room for wheel-chair-bound patients. A significant risk of personal injury, however, both to the patient and to the person or persons assisting the patient, attends the physical transferring of the patient out of the wheel chair and into the examination chair. With such risks of injury comes an increased liability to the provider. Moreover, many providers have neither the office space nor the funds necessary to establish a separate examining room and to equip it with specialized chairs and instrument stands specifically designed to accommodate the disabled. Accordingly, it will be appreciated that other, less-expensive alternatives for providers of eye care to conform to the provisions of the ADA would be welcomed by all of those involved. Especially desired would be an examination chair having an inherent capability to accommodate both ambulatory and wheel-chair bound patients.